Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry

Abstract Background Initial reports have described the poor outcome of unexpected cardiac arrest (CA) in intensive care unit (ICU) among COVID-19 patients in China and the USA. However, there are scarce data on characteristics and outcomes of such CA patients in Europe. Methods Prospective registry...

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Autores principales:	Jonathan Chelly, Gaetan Plantefève, Toufik Kamel, Cédric Bruel, Saad Nseir, Christopher Lai, Giulia Cirillo, Elena Skripkina, Sébastien Ehrminger, Fernando-Daniel Berdaguer-Ferrari, Julien Le Marec, Marine Paul, Aurélie Autret, Nicolas Deye, the ACICOVID-19 study group
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	In-hospital cardiac arrest Intensive care unit SARS-CoV-2 COVID-19 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/26bc595d9b394f7cb142587c097ede98
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spelling	oai:doaj.org-article:26bc595d9b394f7cb142587c097ede982021-11-14T12:05:55ZIncidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry10.1186/s13613-021-00945-y2110-5820https://doaj.org/article/26bc595d9b394f7cb142587c097ede982021-11-01T00:00:00Zhttps://doi.org/10.1186/s13613-021-00945-yhttps://doaj.org/toc/2110-5820Abstract Background Initial reports have described the poor outcome of unexpected cardiac arrest (CA) in intensive care unit (ICU) among COVID-19 patients in China and the USA. However, there are scarce data on characteristics and outcomes of such CA patients in Europe. Methods Prospective registry in 35 French ICUs, including all in-ICU CA in COVID-19 adult patients with cardiopulmonary resuscitation (CPR) attempt. Favorable outcome was defined as modified Rankin scale ranging from 0 to 3 at day 90 after CA. Results Among the 2425 COVID-19 patients admitted to ICU from March to June 2020, 186 (8%) experienced in-ICU CA, of whom 146/186 (78%) received CPR. Among these 146 patients, 117 (80%) had sustained return of spontaneous circulation, 102 (70%) died in the ICU, including 48 dying within the first day after CA occurrence and 21 after withdrawal of life-sustaining therapy. Most of CA were non-shockable rhythm (90%). At CA occurrence, 132 patients (90%) were mechanically ventilated, 83 (57%) received vasopressors and 75 (51%) had almost three organ failures. Thirty patients (21%) had a favorable outcome. Sepsis-related organ failure assessment score > 9 before CA occurrence was the single parameter constantly associated with unfavorable outcome in multivariate analysis. Conclusions In-ICU CA incidence remains high among a large multicenter cohort of French critically ill adults with COVID-19. However, 21% of patients with CPR attempt remained alive at 3 months with good functional status. This contrasts with other recent reports showing poor outcome in such patients. Trial registration: This study was retrospectively registered in ClinicalTrials.gov (NTC04373759) in April 2020 ( https://www.clinicaltrials.gov/ct2/show/NCT04373759?term=acicovid&draw=2&rank=1 ).Jonathan ChellyGaetan PlantefèveToufik KamelCédric BruelSaad NseirChristopher LaiGiulia CirilloElena SkripkinaSébastien EhrmingerFernando-Daniel Berdaguer-FerrariJulien Le MarecMarine PaulAurélie AutretNicolas Deyethe ACICOVID-19 study groupSpringerOpenarticleIn-hospital cardiac arrestIntensive care unitSARS-CoV-2COVID-19Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENAnnals of Intensive Care, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	In-hospital cardiac arrest Intensive care unit SARS-CoV-2 COVID-19 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	In-hospital cardiac arrest Intensive care unit SARS-CoV-2 COVID-19 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Jonathan Chelly Gaetan Plantefève Toufik Kamel Cédric Bruel Saad Nseir Christopher Lai Giulia Cirillo Elena Skripkina Sébastien Ehrminger Fernando-Daniel Berdaguer-Ferrari Julien Le Marec Marine Paul Aurélie Autret Nicolas Deye the ACICOVID-19 study group Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
description	Abstract Background Initial reports have described the poor outcome of unexpected cardiac arrest (CA) in intensive care unit (ICU) among COVID-19 patients in China and the USA. However, there are scarce data on characteristics and outcomes of such CA patients in Europe. Methods Prospective registry in 35 French ICUs, including all in-ICU CA in COVID-19 adult patients with cardiopulmonary resuscitation (CPR) attempt. Favorable outcome was defined as modified Rankin scale ranging from 0 to 3 at day 90 after CA. Results Among the 2425 COVID-19 patients admitted to ICU from March to June 2020, 186 (8%) experienced in-ICU CA, of whom 146/186 (78%) received CPR. Among these 146 patients, 117 (80%) had sustained return of spontaneous circulation, 102 (70%) died in the ICU, including 48 dying within the first day after CA occurrence and 21 after withdrawal of life-sustaining therapy. Most of CA were non-shockable rhythm (90%). At CA occurrence, 132 patients (90%) were mechanically ventilated, 83 (57%) received vasopressors and 75 (51%) had almost three organ failures. Thirty patients (21%) had a favorable outcome. Sepsis-related organ failure assessment score > 9 before CA occurrence was the single parameter constantly associated with unfavorable outcome in multivariate analysis. Conclusions In-ICU CA incidence remains high among a large multicenter cohort of French critically ill adults with COVID-19. However, 21% of patients with CPR attempt remained alive at 3 months with good functional status. This contrasts with other recent reports showing poor outcome in such patients. Trial registration: This study was retrospectively registered in ClinicalTrials.gov (NTC04373759) in April 2020 ( https://www.clinicaltrials.gov/ct2/show/NCT04373759?term=acicovid&draw=2&rank=1 ).
format	article
author	Jonathan Chelly Gaetan Plantefève Toufik Kamel Cédric Bruel Saad Nseir Christopher Lai Giulia Cirillo Elena Skripkina Sébastien Ehrminger Fernando-Daniel Berdaguer-Ferrari Julien Le Marec Marine Paul Aurélie Autret Nicolas Deye the ACICOVID-19 study group
author_facet	Jonathan Chelly Gaetan Plantefève Toufik Kamel Cédric Bruel Saad Nseir Christopher Lai Giulia Cirillo Elena Skripkina Sébastien Ehrminger Fernando-Daniel Berdaguer-Ferrari Julien Le Marec Marine Paul Aurélie Autret Nicolas Deye the ACICOVID-19 study group
author_sort	Jonathan Chelly
title	Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
title_short	Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
title_full	Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
title_fullStr	Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
title_full_unstemmed	Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry
title_sort	incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with covid-19: insight from the multicenter prospective acicovid-19 registry
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/26bc595d9b394f7cb142587c097ede98
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Incidence, clinical characteristics, and outcome after unexpected cardiac arrest among critically ill adults with COVID-19: insight from the multicenter prospective ACICOVID-19 registry

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